WASHINGTON -- It was a quiet week in the nation's capital -- except at the healthcare.gov website, where the number of visits rose as Jan. 1 loomed.

WASHINGTON -- It was a quiet week in the nation's capital -- except at the healthcare.gov website, where the number of visits rose as Jan. 1 loomed.

CMS Flexible on Healthcare.gov Signups

As the deadline for getting health insurance that would be effective on Jan. 1 grew nearer and the number of visits soared, the Centers for Medicare and Medicaid Services (CMS) appeared to be giving consumers a little more time to sign up for health insurance through the federally run healthcare.gov website.

"It was a record day yesterday for healthcare.gov and the Marketplace," CMS spokeswoman Julie Bataille said in an email to reporters Tuesday. "Healthcare.gov alone received a remarkable 2 million site visits and our call center received more than 250,000 calls as consumers were rushing to complete their applications."

The website's call centers remained open until midnight Christmas Eve, but for those who figured they'd miss the Dec. 24 signup deadline, "our highest priority is making sure that everyone who wants to enroll to have healthcare coverage by Jan. 1 is able to do so," she continued. Therefore, for consumers who have had problems, "we have developed a robust casework process to address individual inquiries, respond to specific situations, and help consumers transition to new coverage. Consumers will hear directly from their health plan about the date their coverage is effective."

Allowing consumers to enroll later than the official deadline if there is a problem with the exchange has been a long-standing provision of the Affordable Care Act, a CMS official said.

Parents seeking health insurance for their children will find roughly similar kinds of policies in both the Children's Health Insurance Program (CHIP) and the Affordable Care Act's health insurance exchanges or marketplaces, but the CHIP plans tend to have lower deductibles and less cost-sharing in general, a report from the Government Accountability Office (GAO) found. In the report issued Dec. 20, the GAO looked at CHIP plans in five states -- Colorado, Illinois, Kansas, New York, and Utah -- and compared them with "benchmark" health plans selected by each state as a model for the type of plan it would offer in its health exchange.

"The [CHIP and benchmark] plans were comparable in the services they covered and the services on which they imposed limits, although there was some variation," the report noted. However, "consumers' costs for ... deductibles, copayments, coinsurance, and premiums ... were almost always less in the five selected states' CHIP plans when compared to their respective benchmark plans."

For instance, CHIP plans in each state generally didn't require deductibles at all, but all of the benchmark plans did, the GAO said. Similarly, in Colorado, a doctor's office visit would cost a CHIP enrollee from $2 to $10, depending on the family's income, while the copay in a benchmark plan was $30 for a visit to a primary care doctor and $50 for a specialist visit.

"Although state officials in the five states we reviewed expect the CHIP landscape to remain relatively stable over the next year, uncertainty remains regarding issuer decisions and the implementation of other [ACA] provisions," the authors concluded. "This uncertainty complicates making a definitive determination of what CHIP enrollees would face if they were to obtain [exchange] coverage rather than be enrolled in CHIP."

HHS: 123 More ACOs Have Been Formed

Doctors and hospitals have formed another 123 accountable care organizations (ACOs) in the Medicare program, Health and Human Services (HHS) Secretary Kathleen Sebelius announced Monday. The new ACOs will provide care to an additional 1.5 million Medicare beneficiaries, Sebelius said in a press release.

ACOs are a payment and delivery model where providers -- hospitals, physicians, and others -- who don't normally work together take responsibility for the spending and outcomes of a group of patients and share in cost savings achieved for doing so. Since the passage of the Affordable Care Act, more than 360 ACOs have been formed, and they serve 5.3 million Medicare beneficiaries, the release noted. The new ACOs include a "diverse cross-section" of providers, including some in rural and underserved areas.

To be included in Medicare, the ACOs need to meet certain quality standards to show that savings are coming through improving care coordination and by providing "appropriate, safe, and timely" care, according to HHS. ACOs are evaluated on 33 quality measures, including some dealing with patient and caregiver experience of care, care coordination and patient safety, appropriate use of preventive health services, and improved care for at-risk populations.

Next Week

Capitol Hill will remain quiet next week with Congress out on its holiday break. Business as usual will resume on Monday, Jan. 6.

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